Study Using Pharmacogenetics to Select Treatment for Head and Neck Cancer (PGx-SELECT)
Primary Purpose
Head and Neck Cancer
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Cisplatin
Cetuximab
Sponsored by
About this trial
This is an interventional treatment trial for Head and Neck Cancer focused on measuring Head and neck cancer, pharmacogenetics, chemoradiotherapy
Eligibility Criteria
Inclusion Criteria:
- Biopsy proven squamous cell carcinoma of the head and neck, including of the oral cavity, oropharynx, hypopharynx, or larynx
- Locally advanced, Stage III or IVB disease and a candidate for primary therapy using chemotherapy and radiation with curative intent
- Patients with a diagnosis of 'unknown primary' will be eligible if chemoradiotherapy is primary modality of treatment
- No previous chemotherapy, radiation, or surgery for the diagnosis of head and neck cancer
- ECOG performance status 0 or 1
- Negative pregnancy test
- Hemoglobin >/= 8.0
- Absolute neutrophil count >/= 1500
- Platelet count >/= 100,000
- GFR > 50 mL/min
- Total bilirubin </= 1.5 upper limits of normal
- AST and ALT </= 2.5 times upper limits of normal
- No other current malignancy, other than basal cell skin cancer, squamous cell skin cancer, in situ cervical cancer, ductal or lobular in situ of the breast.
- Ability and willingness to give consent
- Subjects must in the opinion of the Investigator be capable of complying with the protocol
Exclusion Criteria:
- Primary tumors of the nasopharynx, sinuses, and salivary glands
- Acute treatment for an infection or other serious medical illness within 14 days prior to study entry
- Major surgery within 3 weeks prior to study entry
- Known hypersensitivity to cisplatin or cetuximab
- Patients who have any severe or uncontrolled medical conditions or other conditions that could affect their participation in this study including: unstable angina, serious uncontrolled cardiac arrhythmia, active or uncontrolled infectious disorder, myocardial infarction </= 6 months prior to study entry
- Psychiatric illness that would limit compliance with study requirements
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Cetuximab
Cisplatin
Arm Description
patients with 2 or fewer genetic variants will receive cetuximab
Subjects with 3 to 8 genetic variants will receive cisplatin
Outcomes
Primary Outcome Measures
Progression-free survival
Secondary Outcome Measures
Objective response
Overall survival
Toxicity
Quality of Life
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00881114
Brief Title
Study Using Pharmacogenetics to Select Treatment for Head and Neck Cancer
Acronym
PGx-SELECT
Official Title
A Prospective Phase II Clinical Trial to Use Pharmacogenetics (PGx) to Select Erbitux or Cisplatin to Treat Head and Neck Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
April 2009
Overall Recruitment Status
Withdrawn
Why Stopped
Investigator decided it was not feasible to conduct this study
Study Start Date
April 2009 (undefined)
Primary Completion Date
June 2009 (Actual)
Study Completion Date
June 2013 (Anticipated)
3. Sponsor/Collaborators
Name of the Sponsor
Georgetown University
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a study for patients with head and neck cancer who will be receiving chemotherapy and radiation therapy for their disease. The purpose of this study is to see if the investigators can use genetic differences between patients to select the right drug to use with radiation therapy. This type of genetic testing is called pharmacogenetics.
Currently there are two drugs used to treat head and neck cancer that have provided a benefit when given with radiation compared to radiation alone in previous studies. These two drugs are cisplatin and cetuximab (Erbitux).
In this trial, the investigators will test whether genetic differences between patients can be used to pick which drug they should receive. A recent study that looked back to see how well patients with head and neck cancer responded to treatment with cisplatin showed that genetic differences in a few genes were associated with who did and who did not survive their cancer. The investigators are taking that finding and using it to test patients for these genetic differences to determine whether they should receive cisplatin or cetuximab. In other words, the investigators are trying to take what is essentially a flip of the coin choice between these two drugs, and instead use individual patient's genetic differences to make-and hopefully improve- this choice.
Detailed Description
Treatment-naive patients with locally advanced, non-metastatic (Stage III to IVB) squamous cell carcinoma of the head and neck who are candidates for concurrent chemoradiotherapy as primary therapy with curative intent will be enrolled. Patients will be genotyped for variations at four SNP loci in 3 genes involved in DNA nucleotide excision repair (ERCC1, ERCC2, and XRCC1). Patients with 3 to 8 variants will receive cisplatin, while patients with 2 or fewer variants will receive cetuximab.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Cancer
Keywords
Head and neck cancer, pharmacogenetics, chemoradiotherapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cetuximab
Arm Type
Experimental
Arm Description
patients with 2 or fewer genetic variants will receive cetuximab
Arm Title
Cisplatin
Arm Type
Experimental
Arm Description
Subjects with 3 to 8 genetic variants will receive cisplatin
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
cis-diamminedichloridoplatinum(II), CDDP
Intervention Description
Intensity modulated radiation therapy with concurrent chemotherapy. Cisplatin will be administered at a dose of 100 mg/m2 during weeks 1, 4, and 7 of radiation therapy. Post treatment neck dissection will be performed if clinically indicated.
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux
Intervention Description
Intensity modulated Radiation Therapy with concurrent chemotherapy. Cetuximab will be administered beginning at a dose of 400 mg/m2 the week before radiation commences, then at a dose of 250 mg/m2 weekly during weeks 1 to 7. Post treatment neck dissection will be performed if clinically indicated.
Primary Outcome Measure Information:
Title
Progression-free survival
Time Frame
36months
Secondary Outcome Measure Information:
Title
Objective response
Time Frame
36 months
Title
Overall survival
Time Frame
36 months
Title
Toxicity
Time Frame
8 weeks
Title
Quality of Life
Time Frame
36 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Biopsy proven squamous cell carcinoma of the head and neck, including of the oral cavity, oropharynx, hypopharynx, or larynx
Locally advanced, Stage III or IVB disease and a candidate for primary therapy using chemotherapy and radiation with curative intent
Patients with a diagnosis of 'unknown primary' will be eligible if chemoradiotherapy is primary modality of treatment
No previous chemotherapy, radiation, or surgery for the diagnosis of head and neck cancer
ECOG performance status 0 or 1
Negative pregnancy test
Hemoglobin >/= 8.0
Absolute neutrophil count >/= 1500
Platelet count >/= 100,000
GFR > 50 mL/min
Total bilirubin </= 1.5 upper limits of normal
AST and ALT </= 2.5 times upper limits of normal
No other current malignancy, other than basal cell skin cancer, squamous cell skin cancer, in situ cervical cancer, ductal or lobular in situ of the breast.
Ability and willingness to give consent
Subjects must in the opinion of the Investigator be capable of complying with the protocol
Exclusion Criteria:
Primary tumors of the nasopharynx, sinuses, and salivary glands
Acute treatment for an infection or other serious medical illness within 14 days prior to study entry
Major surgery within 3 weeks prior to study entry
Known hypersensitivity to cisplatin or cetuximab
Patients who have any severe or uncontrolled medical conditions or other conditions that could affect their participation in this study including: unstable angina, serious uncontrolled cardiac arrhythmia, active or uncontrolled infectious disorder, myocardial infarction </= 6 months prior to study entry
Psychiatric illness that would limit compliance with study requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Deeken, MD
Organizational Affiliation
Georgetown University
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Study Using Pharmacogenetics to Select Treatment for Head and Neck Cancer
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